Addressing the need for an efficient and effective infrastructure for clinical research in otolaryngology-related disorders, a practice-based research network has been developed under an NIDCD infrastructure grant [DC-07-002]. Entering its fifth and final year of the grant, the CHEER Network - Creating Healthcare Excellence through Education and Research - has evolved to a peer to peer collaboration affiliated in mission to investigate questions that seek to increase and improve medical evidence for effectiveness and quality of care in the ambulatory-based practice setting. The network has been successful in not only recruiting, training and maintaining active sites, but proving the power of the network in deploying a data collection project that enrolled 1,500 patients in only 8 months. CHEER is now ready to extend the CHEER infrastructure into active conduct of research relevant to the otolaryngology community. The achievements thus far have made the network's mission to become a national resource for practice-based clinical research [www.cheerresearch.org] a tenable reality. This application ensures that the success of the CHEER network continues, ultimately becoming a sustainable resource to researchers in otolaryngology and the broader community for clinical trials, epidemiologic, comparative effectiveness and health services research needs. PUBLIC HEALTH RELEVANCE: Healthcare reform, without adequate clinical research and evidence, threatens to impact the treatment options and decisions for patients and their healthcare providers. Loss of hearing and ability to communicate with friends and family is a major risk factor for loss of cognitive function, making it a priority public health concern. With National Health Expenditures growing as a percent of the GDP, estimated at upwards of 20% by 2015, there needs to be investment in the hearing and